Tregterapi

Tregterapi, or regulatory T-cell therapy, refers to strategies that use regulatory T cells (Tregs) to modulate the immune system with the aim of reducing pathological immune responses while preserving general immunity. It is investigated as a form of immunotherapy for autoimmune diseases, transplant tolerance, and inflammatory conditions.

Most approaches use autologous Tregs isolated from the patient’s blood and expanded ex vivo before infusion. Cells are enriched for CD4+ CD25hi CD127low FOXP3+ Tregs from peripheral blood, with cord blood as an alternative source; expansion often uses IL-2 and rapamycin to promote stability.

Mechanistically, Tregs suppress autoreactive T cells, inhibit B cells, and modulate dendritic cells. They act through cytokines such as IL-10 and TGF-beta, and surface molecules like CTLA-4; engineered variants such as CAR-Tregs aim to increase antigen-specific suppression.

Clinical status: Treg therapy is experimental. Early-phase trials in type 1 diabetes, graft-versus-host disease, and inflammatory bowel disease show feasibility and a tolerable safety profile, with signals of efficacy in some cases but no conclusive results. Regulatory oversight requires GMP manufacturing and careful follow-up.

Key challenges include maintaining Treg stability and function after transfer, avoiding over-immunosuppression, manufacturing scale and cost, and standardizing potency assays. Ongoing trials are exploring improved persistence, targeting, and combination regimens.